Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies.
Diabetes is associated with an increased risk of pancreatic cancer (PC) in Western populations. Uncertainty remains, however, about the relevance of plasma glucose for PC among people without diabetes and about the associations of diabetes and high blood glucose with PC in China where the increase i...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Wiley
2017
|
| _version_ | 1797081950402379776 |
|---|---|
| author | Pang, Y Kartsonaki, C Guo, Y Bragg, F Yang, L Bian, Z Chen, Y Iona, A Millwood, I Lv, J Yu, C Chen, J Li, L Holmes, M Chen, Z |
| author_facet | Pang, Y Kartsonaki, C Guo, Y Bragg, F Yang, L Bian, Z Chen, Y Iona, A Millwood, I Lv, J Yu, C Chen, J Li, L Holmes, M Chen, Z |
| author_sort | Pang, Y |
| collection | OXFORD |
| description | Diabetes is associated with an increased risk of pancreatic cancer (PC) in Western populations. Uncertainty remains, however, about the relevance of plasma glucose for PC among people without diabetes and about the associations of diabetes and high blood glucose with PC in China where the increase in diabetes prevalence has been very recent. The prospective China Kadoorie Biobank (CKB) study recruited 512,000 adults aged 30-79 years from 10 diverse areas of China during 2004-08, recording 595 PC cases during 8 years of follow-up. Cox regression yielded adjusted hazard ratios (HRs) for PC associated with diabetes (previously diagnosed or screen-detected) and, among those without previously diagnosed diabetes, with levels of random plasma glucose (RPG). These were further meta-analysed with 22 published prospective studies. Overall 5.8% of CKB participants had diabetes at baseline. Diabetes was associated with almost two-fold increased risk of PC (adjusted HR=1.87, 95% CI 1.48-2.37), with excess risk higher in those with longer duration since diagnosis (p for trend=0.01). Among those without previously diagnosed diabetes, each 1 mmol/L higher usual RPG was associated with a HR of 1.12 (1.04-1.21). In meta-analysis of CKB and 22 other studies, previously diagnosed diabetes was associated with a 52% excess risk (1.52, 1.43-1.63). Among those without diabetes, each 1 mmol/L higher blood glucose was associated with a 15% (1.15, 1.09-1.21) excess risk. In Chinese and non-Chinese populations, diabetes and higher blood glucose levels among those without diabetes are associated with an increased risk of PC. |
| first_indexed | 2024-03-07T01:21:13Z |
| format | Journal article |
| id | oxford-uuid:9068b8a8-5fce-41f7-a59d-eb6849bd6d9a |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T01:21:13Z |
| publishDate | 2017 |
| publisher | Wiley |
| record_format | dspace |
| spelling | oxford-uuid:9068b8a8-5fce-41f7-a59d-eb6849bd6d9a2022-03-26T23:11:25ZDiabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9068b8a8-5fce-41f7-a59d-eb6849bd6d9aEnglishSymplectic Elements at OxfordWiley2017Pang, YKartsonaki, CGuo, YBragg, FYang, LBian, ZChen, YIona, AMillwood, ILv, JYu, CChen, JLi, LHolmes, MChen, ZDiabetes is associated with an increased risk of pancreatic cancer (PC) in Western populations. Uncertainty remains, however, about the relevance of plasma glucose for PC among people without diabetes and about the associations of diabetes and high blood glucose with PC in China where the increase in diabetes prevalence has been very recent. The prospective China Kadoorie Biobank (CKB) study recruited 512,000 adults aged 30-79 years from 10 diverse areas of China during 2004-08, recording 595 PC cases during 8 years of follow-up. Cox regression yielded adjusted hazard ratios (HRs) for PC associated with diabetes (previously diagnosed or screen-detected) and, among those without previously diagnosed diabetes, with levels of random plasma glucose (RPG). These were further meta-analysed with 22 published prospective studies. Overall 5.8% of CKB participants had diabetes at baseline. Diabetes was associated with almost two-fold increased risk of PC (adjusted HR=1.87, 95% CI 1.48-2.37), with excess risk higher in those with longer duration since diagnosis (p for trend=0.01). Among those without previously diagnosed diabetes, each 1 mmol/L higher usual RPG was associated with a HR of 1.12 (1.04-1.21). In meta-analysis of CKB and 22 other studies, previously diagnosed diabetes was associated with a 52% excess risk (1.52, 1.43-1.63). Among those without diabetes, each 1 mmol/L higher blood glucose was associated with a 15% (1.15, 1.09-1.21) excess risk. In Chinese and non-Chinese populations, diabetes and higher blood glucose levels among those without diabetes are associated with an increased risk of PC. |
| spellingShingle | Pang, Y Kartsonaki, C Guo, Y Bragg, F Yang, L Bian, Z Chen, Y Iona, A Millwood, I Lv, J Yu, C Chen, J Li, L Holmes, M Chen, Z Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies. |
| title | Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies. |
| title_full | Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies. |
| title_fullStr | Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies. |
| title_full_unstemmed | Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies. |
| title_short | Diabetes, plasma glucose and incidence of pancreatic cancer: A prospective study of 0.5 million Chinese adults and a meta-analysis of 22 cohort studies. |
| title_sort | diabetes plasma glucose and incidence of pancreatic cancer a prospective study of 0 5 million chinese adults and a meta analysis of 22 cohort studies |
| work_keys_str_mv | AT pangy diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT kartsonakic diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT guoy diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT braggf diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT yangl diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT bianz diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT cheny diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT ionaa diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT millwoodi diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT lvj diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT yuc diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT chenj diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT lil diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT holmesm diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies AT chenz diabetesplasmaglucoseandincidenceofpancreaticcanceraprospectivestudyof05millionchineseadultsandametaanalysisof22cohortstudies |